This U10 proposal responds is to establish an NIMH Research Unit for Pediatric Psychopharmacology --Psychosocial Intervention (RUPP-PI) in New York City. The proposed unit combines the recruiting strengths and expertise of two urban university medical centers -New York State Psychiatric Institute and New York University's Child Study Center -in clinical epidemiology of suicidal behavior, psychosocial treatment development, pharmaco- kinetics of stimulants, and participation in numerous successfully performed, single and multi-site clinical trials involving psychosocial interventions, selective serotonin reuptake inhibitors, and their combination for mood and anxiety disorders. Resources to support this program of research and training include T32 postdoctoral training grants in child psychiatry research, an Intervention Research Center on child psychiatric disorders, and a RUPP devoted to treatment of anxiety disorders. This application's exemplar research protocol, "Treatment of Suicidal Adolescent Attempters" (TASA), targets a major public health issue: although adolescents in this country suffer 2 million suicide attempts annually, no large scale, multimodal controlled intervention studies for this condition have been conducted. The proposed 5 year study will determine the effectiveness of a multi-modal treatment intervention to prevent further reattempts in 480 depressed adolescent attempters, ages 12 to 18, at 8 sites. Eligible subjects will be recruited, carefully assessed, and then randomized equally to two treatment conditions. The Experimental Treatment group will receive a 24 week course integrating antidepressant medication management (MM) with cognitive behavioral therapy. The Control Treatment group will be referred to a community provider for standard clinical care plus enhanced clinical monitoring and case management to encourage treatment adherence. Both groups will be assessed at baseline 2, 4, 8, 12, 24, 36 and 48 weeks by an independent evaluator blind to treatment assignment. We hypothesize that the experimental treatment will result in fewer suicide attempts, diminished depression and severity of suicidal ideation, and greater global improvement scores than in the control group over a one year period of observation. The expertise and experience at this RUPP-PI site also will be directed to train new investigators. In creating TASA, a collaborative group of 8 RUPP-PI applicants forged the ability to work together.